术前中性粒细胞/淋巴细胞比值对cN0期甲状腺微小乳头状癌中央区淋巴结转移的预测价值

目的 探讨cN0期甲状腺微小乳头状癌(PTMC)的临床特点以及中央区淋巴结转移的独立危险因素以及术前中性粒细胞/淋巴细胞比值(NLR)能否作为预测cN0期PTMC中央区淋巴结转移的指标之一。 方法 回顾性分析蚌埠医学院第一附属医院肿瘤外科2018年1—12月收治的120例cN0期PTMC患者的临床及病理资料,分析其中央区淋巴结转移的危险因素。应用ROC曲线预测术前NLR对中央区淋巴结转移的影响,并分析术前NLR与cN0期PTMC患者临床病理之间的关系以及术前NLR与PTMC患者肿瘤直径之间的关系。 结果 在所有120例cN0期PTMC患者中51例(42.5%)发生中央区淋巴结转移,单因素分析结果显示中央区淋巴结转移与肿瘤直径、伴有包膜侵犯、多灶性、术前NLR和术前血小板/淋巴细胞比值(PLR)有关(均P<0.05),而与性别、年龄及肿瘤位置无关(均P>0.05)。多因素分析发现肿瘤直径、多灶性和包膜侵犯以及NLR是PTMC中央区淋巴结转移的危险因素。单因素分析结果显示术前NLR与肿瘤直径有关(P<0.05),而与性别、年龄、肿瘤位置、多灶性、包膜侵犯无关(均P>0.05)。Spearman等级相关分析显示术前NLR与患者的肿瘤直径呈正相关(r=0.434,P<0.001)。 结论 cN0期PTMC中央区淋巴结转移与多种因素有关,对于存在这些高危因素的患者应行预防性中央区淋巴结清扫;术前NLR可以预测cN0期PTMC中央区淋巴结转移,且与肿瘤直径呈正相关。 

The predictive value of preoperative neutrophil-to-lymphocyte ratio for central node lymph node metastasis in cN0 patients with papillary thyroid microcarcinoma

Objective To explore the clinical features of cN0 patients with papillary thyroid microcarcinoma(PTMC) and the risk factors of central lymph node metastasis in cN0 patients PTMC, and whether preoperative NLR can be used as one of the indicators to predict central lymph node metastasis of PTMC. Methods The clinical and pathological data of 120 cN0 patients with PTMC admitted to the Department of Oncology, the First Affiliated Hospital of Bengbu Medical College from January 2018 to December 2018 were retrospectively analyzed. The clinical characteristics of cN0 patients with PTMC and the risk factors of central lymph node metastasis were analyzed. The ROC curve was used to predict the effect of preoperative NLR on central lymph node metastasis, and the relationship between preoperative NLR and clinicopathology of PTMC and the relationship between preoperative NLR and tumor size were analyzed. Results In 120 cN0 patients with PTMC, 51(42.5%) central lymph node metastases was occurred. Univariate analysis showed the tumor size, capsule invasion, multifocality, preoperative NLR and preoperative PLR were related to central lymph node metastasis(all P<0.05), but not related to gender, age and primary tumor location(all P>0.05). Multivariate analysis found that the tumor size, multifocality, capsule invasion and preoperative NLR were the risk factors for central lymph node metastasis of cN0 patients with PTMC. Univariate analysis showed preoperative NLR was related to tumor size(P<0.05), but not related to gender, age, primary tumor location, multifocality and capsule invasion(all P>0.05). Spearman's correlation coefficient for ranked data showed preoperative NLR related to tumor size(r=0.434, P<0.001). Conclusion The central lymph node metastasis of cN0 patients with PTMC is related to many factors. For patients with these high-risk factors, prophylactic central node lymph node dissection should be performed. NLR can predict the central lymph node metastasis of cN0 patients with PTMC, which is related to the tumor size.